Method in Theology and Oncology: Bernard Lonergan's Cognitional Theory and the Foundations of Medicine and Religion

David de la Fuente, MTS, Doctoral Student, Department of Theology, Fordham University

The cognitional theory of Jesuit philosopher and theologian Bernard Lonergan offers a remarkable treatment of human insight, oversight, and the dialectical process of conversion that applies equally to religious life and to medical practice and research. For Lonergan, the goal of human intelligence is ultimately to participate in the nature of the Triune God, who is “an infinite and substantial act of understanding.” The human as a knower participates in a community of knowers, whose specializations in various fields of knowledge coalesce into a system of understanding. To actualize this, humanity is called to observe four transcendental precepts in the whole process of human knowing: be attentive, intelligent, reasonable, and responsible with regard to our experiences and encounters. Self-transcendence is achieved in authentic knowing and praxis, as well as in the process of conversion that safeguards against oversight, bias, and decline by constantly reversing “counterpositions” and refining practices.

What Lonergan describes is inspired both by religious faith and by the working of the scientific method. One may even assert that Lonergan’s description of theological method is also operative in healthcare, especially in oncology. In the practice of the multidisciplinary tumor board, one witnesses physicians and professionals across a variety of related specialties sharing insights, critiquing oversights, and constantly discerning together the best method of care for difficult cases. Furthermore, they analyze their practices and share their research with the rest of the medical community to either confirm authentic practices or discourage less effective ones. In short, they are in this context often attentive, intelligent, reasonable, and responsible. The tumor board conference, then, is a concrete example of human transcendence in healthcare.

Inspired both by Lonergan’s works on insight and method, and by personal experience working alongside and witnessing head and neck oncologists, this paper argues that the quest for human transcendence offers the shared foundation for religion and medicine. I will proceed as follows: first, I will describe Lonergan’s cognitional theory and identify its connections with method in healthcare. I will then turn to two brief examples in healthcare, the practice of the tumor board conference as well as a recent change in clinical practice guidelines for thyroid cancer, and from these elucidate how Lonergan’s cognitional theory illuminates the transcendental patterns of human knowing and practice at work here. I will conclude by briefly suggesting insights from healthcare practice that can enrich theological reflection. In these processes of research and refinement, one sees a model of communal discernment and objectivity that theologians and pastors can emulate and use to ground their activity. Human understanding is a transcendental event; for Lonergan, in the final analysis, this event reflects God’s own nature as an act of understanding.